Provider Demographics
NPI:1881677235
Name:EICHLER, MARC (MD)
Entity Type:Individual
Prefix:DR
First Name:MARC
Middle Name:
Last Name:EICHLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:831 BEACON ST
Mailing Address - Street 2:SUITE 239
Mailing Address - City:NEWTON CENTRE
Mailing Address - State:MA
Mailing Address - Zip Code:02459-1822
Mailing Address - Country:US
Mailing Address - Phone:605-430-7632
Mailing Address - Fax:
Practice Address - Street 1:831 BEACON ST
Practice Address - Street 2:SUITE 239
Practice Address - City:NEWTON CENTRE
Practice Address - State:MA
Practice Address - Zip Code:02459-1822
Practice Address - Country:US
Practice Address - Phone:605-430-7632
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-21
Last Update Date:2012-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA160084207T00000X
NDND7789207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAG52490Medicare UPIN
NDG52490Medicare UPIN